Individual
MS. REINA MARIE DASTOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
85 HERRICK ST, BEVERLY, MA 01915-1790
(978) 927-7880
(978) 524-6082
Mailing address
LAHEY CLINIC INC., PROVIDER ENROLLMENT DEPARTMENT, 41 MALL ROAD, BURLINGTON, MA 01805
(781) 744-8085
(781) 744-5433
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
245530
MA
Other
Enumeration date
06/14/2007
Last updated
02/01/2018
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